Provider Demographics
NPI:1235285289
Name:TOWN OF LITTLE ELM
Entity Type:Organization
Organization Name:TOWN OF LITTLE ELM
Other - Org Name:LITTLE ELM FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-795-0420
Mailing Address - Street 1:100 W ELDORADO PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5060
Mailing Address - Country:US
Mailing Address - Phone:214-975-0420
Mailing Address - Fax:214-975-0776
Practice Address - Street 1:101 HARDWICKE LN
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-5202
Practice Address - Country:US
Practice Address - Phone:214-975-0420
Practice Address - Fax:214-975-0420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
TX610073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX508920OtherBLUE CROSS BLUE SHIELD
TX000236201Medicaid
TX508920OtherBLUE CROSS BLUE SHIELD
TX000236201Medicaid